Floods can leave communities facing higher overdose deaths for years

Hollr Harm Reduction is an organization in Madison County, North Carolina, that provides needles, naloxone, and other supplies to help prevent overdoses and infections among residents still recovering from Hurricane Helene. While overdose rates have generally been decreasing, there have been unusual spikes that appear to be linked to the hurricane. Financial stress, trauma, and unstable housing have disrupted recovery efforts and contributed to dangerous substance use patterns.

A study by Pennsylvania State University found that severe flooding in economically distressed Appalachian counties correlates with higher overdose death rates. These increases can last for at least a decade after the water recedes. Kristina Brant, the study's lead author, discovered that services can be interrupted for a very long time in small communities where people have to wear many hats.

Overdose deaths in flooded counties increased by about 28 percent over ten years, compared to a 26 percent rise in the non-flooded counties.

The reasons behind these long-term effects include disrupted services, prolonged instability in housing and employment, and the lasting impact of trauma. After the hurricane, a clinic in the area closed due to the costs of reopening, and methadone treatments were disrupted, forcing some individuals to return to illicit opioids, which can be particularly dangerous for recent recovery or use.

Cassie York, a behavioral health worker in Yancey County, North Carolina, noted that the flooding killed 10 people and destroyed thousands of homes, exacerbating the housing shortage.

Hollr Harm Reduction and other direct service workers believe their insights should be included in disaster planning and recovery discussions. Healthcare providers are starting to support this idea, emphasizing that improving access to care before and after disasters can help limit disruptions for rural communities.